Arterial Dissections

Arterial dissections occur when there is a tear or damage to the inner wall or lining of an artery. Dissections occur most often in the aorta, the carotid artery and the vertebral artery.

An aortic dissection occurs when the inner layer or lining of the aorta tears and allows blood to enter into the wall of the aorta. The aorta is the largest blood vessel in the body and carries blood from the heart to all of the body’s major organs, except the lungs.

Development of an arterial dissection. Blood enters the inner wall of an artery through a tear, eventually causing separation of the layers of the arterial vessel wall.
When the inner layer of the aorta tears, blood enters the aortic wall and “dissects” or separates the layers of the aorta from one another. This decreases the strength of the aorta and can lead to a life-threatening rupture, burst or leak. 

Dissections in these arteries can lead to serious health problems, including:

How to Diagnose Arterial Dissections

The diagnostic tools depend on the type of suspected dissection. We commonly use:

  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI) scan or magnetic resonance angiography (MRA)
  • Angiography
  • Ultrasound
  • Echocardiograpy

Treatment for Arterial Dissections at UVA

All aortic dissections can be life-threatening and need to be diagnosed immediately for appropriate treatment to be successful. You'll require medical therapy to keep your heart rate and blood pressure low.

Surgery

UVA is a national leader in the use of stent-grafts and is a regional center for patients with any arterial dissection, particularly aortic dissections.

You may need immediate surgery to prevent complications such as heart attack, stroke or rupture. Surgery replaces the area of the aorta where the dissection began. This operation is a lot like open-heart surgery and involves an incision on the front of the chest and the use of the heart and lung machine. Only one area of the aorta is repaired, which leaves a residual dissection in the remainder of the aorta. You'll need to take blood pressure medication and get periodic CT scans.

Medications

Most other dissections can be treated with medication, especially those that lower the blood pressure and heart rate. This type of treatment allows the dissection to stabilize and sometimes heal spontaneously. 

Life After Treatment

After treatment, you might be at risk of an aneurysm due to the weakened aortic wall. Blood pressure medication can lower these chances. If an aneurysm does form, it can nearly always be treated with additional surgery. At UVA, we use specialized stent-grafts that allow repair of some dissections (or dissection related aneurysms) without the need for major chest surgery.

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Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.

 

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